Medical Coding and Billing: 5 Common ICD-10 Errors

Medical Coding and Billing: 5 Common ICD-10 Errors

ICD-10, which replaces ICD-9 in 2015, is a much more complex and expansive coding system than had been previously used. The ICD-9 system was implemented in the late 1970s, and the sheer magnitude of changes that have occurred in the medical field in what is close to 40 years is mind boggling. The new codes reflect those changes and, also, reveal how specific and detailed medical procedures have become in the treatment of injuries and illnesses.

Because the ICD-10 system has almost five times as many codes as the ICD-9 system, it is a breeding ground for a range of common mistakes that can compromise a medical practice or hospital’s fiscal viability. Here are five common ICD-10 errors you will want to avoid.

Wrong Code

It is as simple as using the wrong code. This mistake may include selecting the wrong ICD-10 code or still using, automatically, the old ICD-9 code. Careful selection of the proper code is important. Submitting the wrong code will probably be the most common mistake made in the first two to three years of adjustment that will occur in transitioning from ICD-9 to ICD-10.

Insufficient Codes

One of the aspects of ICD-10 that makes it so much more complicated that ICD-9 is the fact that there are so many new codes, and, at the same time, a whole range of never before used sub-codes.

Thus, as an example, it’s very easy for someone to leave out the code indicating if a procedure or treatment is being administered for the first time or if it is an additional treatment. Codes specifically identifying where an injury occurred, specifically how it affected the body, and the reoccurrence or ongoing nature of the malady are all important elements of the new coding system.

Inconsistent ICD-10 CM or PCS Codes

The ICD-10 CM codes, that is clinical modification codes, are used by healthcare professionals in all settings except inpatient, and the ICD-10 PCS codes, which is the procedural coding system, are used for medical diagnoses in the inpatient setting only. These are similar to the ICD-9 codes, and yet different enough to cause confusion and inconsistency when reporting.

As an example, the first three digits of an ICD-10 CM code are similar to the ICD-9 CM, but ICD-10 CM has additional digits that clarify to what type of situation the code relates. The same is true for ICD-10 PCS, with the digits following the decimal point adding specificity in describing the procedure.

Input Errors

Common input errors that will cost time, money, ad effort, include typing the uppercase letter “O” instead of a “0” (zero) and the inputting of a the lowercase letter “l” instead of the number “1” (one). These are very simple mistakes and, yet, they occur frequently.

Relying on Coding Software

Although medical billing and coding software is necessary and important, there needs to be a human component in this process that is knowledgeable concerning the new and old coding system and that is vigilant in terms of recording, reporting, and rectifying information.

Thus, making sure that your medical billers and coders are proficient, efficient, and dedicated in their efforts will help to ensure that the possible adverse affect that ICD-10 may have on your medical practice is mitigated.

Taking Action

Taking measures to negate these five common mistakes are important in making a smooth transition from ICD-9 to ICD-10. Make sure that you communicate with everyone involved in the medical coding and billing process in identifying and discussing these common errors and any others that may be specific to your practice.

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